Dean wants General to remain 'viable' part of health care system

Created 05/19/2009 - 11:53pm

Mayor Karl Dean offered instruction as he kicked off the first meeting of a community advisory board Tuesday.

“We want to see General Hospital remain a viable part of the city’s health care system,” said Dean, adding that he wants the process to lead to where “we’re also in a position where we’re controlling the cost to the Metropolitan government.”

The board’s task is to provide expertise to a consulting firm hired to examine how Metro pays for, and provides health care for, those who can’t afford to pay.

The city subsidized the Hospital Authority, which oversees the hospital and long-term and adult day care facilities, about $50 million this year and the mayor’s office has proposed to cut the authority’s budget by 10 percent for the fiscal year starting in July. It has hired health care consulting firm John Snow Inc., to assess ways to provide more cost-effective care.

However, Dean and Finance Director Richard Riebeling cautioned that this process is about more than just cutting costs.

“I think there have been management studies done on the day-to-day operations of the hospital,” Riebeling said. “I think the focus is broader than that, and that [would be] what’s the best model for health care delivery needs to the medically poor and underserved. From my perspective if we can also save money in the process, that’s as critical.”

The team from John Snow Inc, will spend about four months working up recommendations. The first order of business will be to interview stakeholders.

“[That includes] underserved folks to see what their needs are, how their needs are currently being met and how they would recommend meeting their needs,” explained Reesa Webb, the manager for the project.

Many on the advisory board, including HCA Chairman Jack Bovender, say the key to curbing costs at General will be to increase access to primary care. The idea is that if people have a primary care physician they see on a regular basis, they’ll be healthier and less likely to make costlier emergency room visits.

“We get a lot of women presenting themselves in active labor at our emergency rooms having no prenatal care,” Bovender said. “The incidence of complications in [those] pregnancies and then the neo-natal intensive care babies it presents drives up the cost of health care dramatically.”

The consultants’ work may provide long-term solutions, but will not change the short-term budget outlook for Nashville General Hospital.

Riebeling said that the proposed $4.6 million cut for the hospital shouldn’t translate to cuts in services, though Metro Councilman Jerry Maynard has been concerned that may be the case. The councilman is holding a rally, along with Nashville clergy, on Thursday to demonstrate support for the hospital.

The Metro Council budget hearing for the Hospital Authority is scheduled for Thursday.